Correct Diagnosis of Vascular Encasement and Longitudinal Extension of Hilar Cholangiocarcinoma by Four-Channel Multidetector-Row Computed Tomography

Okumoto, Tadayuki; Sato, Akihiro; Yamada, Takayuki; Takase, Kei; Matsuhashi, Toshio; Tsuda, Masashi; Seiji, Kazumasa; Ishibashi, Tadashi; Higano, Shuichi; Katayose, Yu; Unno, Michiaki; Takahashi, Satoshi

doi:10.1620/tjem.217.1

Cited by 27 publications

(15 citation statements)

References 13 publications

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“…These criteria were closely related to the CT diagnostic criteria of Okumoto et al [4] for vascular invasion. The schematic diagram in the Figure 2 illustrates our classification of invasion and comparison with JSBS classification for surgery and pathology as well as the CT classification used by Okumoto et al [4]. As example, we showed JSBS classification of extrahepatic bile duct cancer in Table IB.…”

Section: Mdct Criteria For Diagnosis and Rules For Classification Of mentioning

confidence: 93%

“…On the other hand, the development of multidetector computed tomography (MDCT) allowed establishing accurate diagnosis, especially in vertical extension [3], that is, invasion of the hepatic artery or portal vein. Okumoto et al [4] reported the relationship between CT images of biliary tract tumors and histopathological invasion.…”

Section: Introductionmentioning

confidence: 99%

“…Based on the above reasons, we evaluated the prognostic factors in MDCT-based preoperative diagnosis in patients who were planned for curative resection. For the evaluation, we established criteria for MDCT-based diagnosis based on the surgical criteria of JSBS [1], which were also closely related to the CT-based diagnostic criteria recommended by Okumoto et al [4]. This approach stemmed from the lack of appropriate criteria for MDCT-diagnosis that correlate with the surgical and pathological classifications.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies reported the relationship between diagnosis by MDCT and pathological diagnosis [4][5][6][7][8][9][10][11][12][13] in about 20 patients; however, there was no data for the respectability and/or the prognosis related to MDCT diagnosis. Recently, another strategy for biliary cancer, other than surgery, for example, chemotherapy with or without irradiation, has been tested.…”

Section: Introductionmentioning

confidence: 99%

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Multidetector computed tomography for preoperative prediction of postsurgical prognosis of patients with extrahepatic biliary cancer

Kobayashi¹,

Nagano²,

Marubashi³

et al. 2010

Journal of Surgical Oncology

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Section: Mdct Criteria For Diagnosis and Rules For Classification Of mentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Multidetector computed tomography for preoperative prediction of postsurgical prognosis of patients with extrahepatic biliary cancer

Kobayashi¹,

Nagano²,

Marubashi³

et al. 2010

Journal of Surgical Oncology

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“…The macro- and microscopic features of cholangiocarcinoma explain the extreme limitations in detecting longitudinal tumor extent along the bile ducts and also radial spread into adjacent structures by preoperative radiological and endoscopic imaging [6]. Furthermore, in patients with biliary stents, local artifacts and secondary inflammatory changes can additionally limit the diagnostic accuracy of imaging.…”

Section: Introductionmentioning

confidence: 99%

Surgical Therapy of Cholangiocarcinoma

Radtke

Königsrainer

2016

Visc Med

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Background: The majority of patients with cholangiocarcinoma present with advanced disease that is often challenging to diagnose and to treat. The optimal preoperative evaluation requires a coordinated multidisciplinary approach. Surgical resection is the mainstay of therapy. Methods: This systematic review delineates surgical treatment strategies for cholangiocarcinoma in general as well as special considerations concerning the particular tumor localization. A literature search (see keywords) was conducted using PubMed and publications between 1990 and 2016 regarding resectable and advanced cholangiocarcinoma were reviewed. Selected studies were utilized based on their significance and innovation. Results: The type and extent of resection performed depends on the location of the cholangiocarcinoma within the liver or biliary tree and the extent of local tumor invasion. The common surgical strategy contains: (i) for intrahepatic tumors: tailored partial hepatectomy combined with extended hilar, suprapancreatic, celiac axis lymphadenectomy, (ii) for hilar tumors: complete resection of the extrahepatic biliary tree combined with extended hepatectomy inclusive of segment I, resection of portal vein bifurcation, and systematic N1/N2 lymphadenectomy, and (iii) for distal tumors: en bloc pancreatoduodenectomy combined with complete resection of the extrahepatic bile duct below the hepatic confluence and systematic N1/N2 lymphadenectomy. Pathologic confirmation is not required prior to resection. Preoperative biliary drainage and remnant liver volume augmentation are necessary in selected patients with intrahepatic or hilar cholangiocarcinoma considered for extensive liver resection. Conclusion: Cure for cholangiocarcinoma requires complete surgical resection with histologically negative margins. R0 resection provides a satisfactory long-term outcome in patients with lymph node-negative stage. Neoadjuvant treatment followed by liver transplantation provides long-term survival in highly selected cases with localized, unresectable, lymph node-negative hilar cholangiocarcinoma.

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New staging system and a registry for perihilar cholangiocarcinoma

DeOliveira¹,

et al. 2011

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Perihilar cholangiocarcinoma is one of the most challenging diseases with poor overall survival. The major problem for anyone trying to convincingly compare studies among centers or over time is the lack of a reliable staging system. The most commonly used system is the Bismuth-Corlette classification of bile duct involvement, which, however, does not include crucial information such as vascular encasement and distant metastases. Other systems are rarely used because they do not provide several key pieces of information guiding therapy. Therefore, we have designed a new system reporting the size of the tumor, the extent of the disease in the biliary system, the involvement of the hepatic artery and portal vein, the involvement of lymph nodes, distant metastases, and the volume of the putative remnant liver after resection. The aim of this system is the standardization of the reporting of perihilar cholangiocarcinoma so that relevant information regarding resectability, indications for liver transplantation, and prognosis can be provided. With this tool, we have created a new registry enabling every center to prospectively enter data on their patients with hilar cholangiocarcinoma (www.cholangioca.org). The availability of such standardized and multicenter data will enable us to identify the critical criteria guiding therapy. (HEPATOLOGY 2011;53:1363-1371 C holangiocarcinoma (CCA) arises from the malignant transformation of the bile duct epithelium; it represents approximately 10% of all primary hepatobiliary cancers and accounts for approximately 2% of all malignancies.1,2 Several lines of evidence indicate that the incidence of CCA has increased over the past 3 decades.3,4 These tumors can develop anywhere along the biliary tree and represent a quite heterogeneous group with distinct patterns, epidemiologies, clinical presentations, and prognoses. The most commonly used classification of CCA has three groups based on the location along the biliary tree: intrahepatic cholangiocarcinoma (IHC); perihilar cholangiocarcinoma (PHC), which is also called a Klatskin tumor 5 ; and distal CCA. The IHC type accounts for less than 10% of the total cases, whereas the PHC type represents about two-thirds of the cases, and distal CCA represents about a quarter of the cases.6 PHC can be defined as tumors that involve or are in close vicinity to the bile duct confluence. We suggest a definition of PHC, which includes tumors above the junction of the cystic duct up to and including the second biliary branches of the right and left bile ducts.The only chance of a cure for this type of cancer is complete surgical resection of the tumor and perhaps liver transplantation in highly select cases. Most of these cancers have a dismal prognosis, and the current 5-year

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Correct Diagnosis of Vascular Encasement and Longitudinal Extension of Hilar Cholangiocarcinoma by Four-Channel Multidetector-Row Computed Tomography

Cited by 27 publications

References 13 publications

Multidetector computed tomography for preoperative prediction of postsurgical prognosis of patients with extrahepatic biliary cancer

Multidetector computed tomography for preoperative prediction of postsurgical prognosis of patients with extrahepatic biliary cancer

Surgical Therapy of Cholangiocarcinoma

New staging system and a registry for perihilar cholangiocarcinoma

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